Placental proteins in high-grade urothelial neoplasms. An immunohistochemical study of human chorionic gonadotropin, human placental lactogen, and pregnancy-specific beta-1-glycoprotein

Abstract

We examined the presence of human chorionic gonadotropin (HCG) in 16 low-grade and 47 high-grade urothelial neoplasms, including two cases with trophoblastic-like differentiation. In HCG-positive tumors, the presence of human placental lactogen (HPL) and pregnancy-specific beta-1-glycoprotein (SP-1) also was assessed. HCG immunoreactive cells were found in nine of the 47 high-grade tumors (19%), whereas none of the low-grade tumors were positive for HCG. This hormone was predominantly detected in the most undifferentiated and pleomorphic areas; however, HCG-positive cells also were found in areas of carcinoma in situ and well-differentiated transitional cell carcinoma in two cases. The serum HCG level was increased in two of the four cases studied. HPL and SP-1 immunoreactive cells were observed in seven and five cases, respectively, and it was found that tumors positive for SP-1 also were positive for HPL. Five tumors, including the two with trophoblastic differentiation, contained the three placental proteins. The HPL and SP-1 immunostained cells were usually found in the same areas of the tumor that were positive for HCG, but there was always a lower number of HPL and SP-1 immunoreactive cells than HCG immunoreactive cells. In one case, HPL and SP-1 could be found in areas of well-differentiated transitional cell carcinoma. These findings suggest that the morphologic and functional trophoblastic differentiation in urothelial carcinomas is a progressive phenomenon evolving from transitional cell carcinomas.

Interaction of Pregnancy-Specific Glycoprotein 1 With Integrin α5β1 Is a Modulator of Extravillous Trophoblast Functions

“…PSGs are expressed predominantly, but not exclusively in trophoblasts as low levels of expression were detected in a healthy colon and in the squamous epithelium of the esophagus [19,20]. PSG expression has also been reported in tumors of trophoblastic and non-trophoblastic origin [21,22,23]. Similar to the presence of human PSGs in non-placental tissues, mouse PSG18 is expressed in the follicle-associated epithelium of Peyer’s patches potentially playing a role in the interplay between epithelial cells and immune cells in mucosa-associated lymphoid tissue [24].…”

Prolonged Remission of Upper Urinary Tract Urothelial Carcinoma With Prominent Choriocarcinomatous Differentiation: A Case Report

“…4, 7–10 One study found that 9 out of 47 high-grade urothelial neoplasms expressed hCG on immunohistochemistry, and two of these tumors demonstrated trophoblastic-like differentiation. 9 Alternatively, choriocarcinomas may originate from multipotent embryonal cells that became arrested during migration in ectopic locations. However, the majority of such extragonadal germ cell tumors arise from midline structures anywhere between the level of the pineal gland to the coccyx.…”

Primary choriocarcinoma of the renal pelvis presenting as intracerebral hemorrhage: a case report and review of the literature

“…In only one of those cases was the neoplasm situated in the renal pelvis and the 54-year-old patient had been treated with nephrectomy. Histological examination of this tumor revealed a transitional cell carcinoma with choriocarcinomatous elements [4]. Grammatico et al described the case of a TCC with choriocarcinomatous differentiation involving the pelvoureteric junction of the kidney in an 84-year-old man with hematuria [2].…”